| Organization Name: | KENNETT RADIOLOGY ASSOCIATES |
| NPI Number: | 1083878284 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE BEACHAM (CONTROLLER) |
| Mailing Address: | 1301 1st St Kennett |
| State: | MO US |
| Postal Code: | 638572525 |
| Phone Number: | 5738888424 |
| Fax Number: | 5738882715 |
| NPI Enumeration Date: | 07/16/2008 |
| NPI Last Update Date: | 07/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | R2G95 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |